AIDS Daily Summary
October 26, 1993
The Centers for Disease Control and Prevention (CDC) National AIDS
Clearinghouse makes available the following information as a public
service only. Providing this information does not constitute endorsement
by the CDC, the CDC Clearinghouse, or any other organization. Reproduction
of this text is encouraged; however, copies may not be sold, and the CDC
Clearinghouse should be cited as the source of this information.
Copyright 1993, Information, Inc., Bethesda, MD
"HIV Infection Mechanism Discovered"
Washington Post (10/26/93) P. A13
Researchers at France's Pasteur Institute claim to have
discovered how the AIDS virus penetrates and infects blood cells,
a finding which could have major implications in the development
of a vaccine. The team said it found a "co-receptor" molecule
called CD26, which was identified several years ago, but whose
function remained a mystery. According to the researchers, CD26
is used by all strains of the virus as a gateway into blood
cells. Although they have known for years that HIV adheres to
surface receptor molecules known as CD4, scientists still did not
know how the virus actually got inside the cells to contaminate
them, said Ara Hovanessian, head of the Pasteur Institute team.
"The presence and functioning of the CD26 molecule are
indispensable for the infection and spread of the virus in the
CD4 cells," said a statement from the Institute. "In viral
infections, the CD4 serves as the contact point for viral
particles, while CD26 serves as the main door." The existence of
this second receptor molecule sheds light on possible strategies
to develop a vaccine that will "lock out" HIV, said the
researchers. "The AIDS virus has always managed to have the key
to open the CD4 receptor lock," said Hovanessian. "We hope to be
able to develop drugs capable of jamming the CD26 lock so that
the AIDS key will no longer fit." Because every strain of the
disease uses CD26 to infect cells, researchers hope to develop a
universal vaccine. Related Story: New York Times (10/26) P. C1;
Wall Street Journal (10/26) P. B18; Philadelphia Inquirer (10/26)
P.A7; Washington Times (10/26) P. A3
"8 Counties' AIDS Fight Gets Boost"
Chicago Tribune (10/25/93) P. 1-3 (Thomas, Jerry)
Until recent times, many residents and officials in the Chicago
collar counties refused to acknowledge that HIV/AIDS was a major
health concern in their areas, and those who had contracted the
virus had to travel long distances and be treated in secrecy to
receive primary care and medicine. As the number of persons
infected has climbed in the collar counties, however, attitudes
have changed as well. AIDS experts from across Illinois met at a
seminar last week, where it was announced that eight northeastern
counties would now be eligible for federal funding that has been
available primarily to Chicago, which will now be obliged to
share the money from the Ryan White Care Act. Between January
1981 and September 1993, there were 18,566 people infected with
HIV in Cook County, compared to only 1,164 in the collar
counties. The city and suburbs have different purposes outlined
for the funding. While the city is already underfunded and
overwhelmed with patients, the suburbs are trying to implement
basic services, such as counseling and referral.
"Texas Health Officials Recall 3 Million Condoms"
United Press International (10/25/93)
Austin, Texas--State health officials in Texas yesterday recalled
about 3 million condoms made in Thailand and distributed
throughout the state by agency contractors. The condoms, which
may be defective, were distributed under the brand names Fame,
Bulldog, and Prestige, said David Smith, state health
commissioner. "We're issuing this recall to protect consumers
from a potentially ineffective and harmful product," said Smith.
"Consumers should be reassured that other brands of condoms are
safe and effective." State health officials learned that,
although previous shipments by the same Thai manufacturer were
found to be faulty and not allowed to be imported, the Food and
Drug Administration did not sample the new shipment of condoms.
Smith says the recall proves that "even the few defective condoms
that escaped the federal system can be quickly discovered and
removed from the market." He added that the department will
replace the condoms and reimburse the state for all related
costs.
"Good Nutrition May Delay Onset of AIDS"
United Press International (10/25/93)
San Francisco--Good nutrition, combined with a daily
multivitamin, may stall the development of AIDS in a significant
percentage of HIV-positive men, according to a study presented
yesterday at a major health meeting. The large, long-term
followup of some 300 San Francisco men infected with the virus
indicated that multivitamin use seemed to protect nearly a third
of them from the onset of full-blown AIDS over a six-year time
frame. Researchers from the University of California, Berkeley,
said that specific nutrients from food and supplements also
appeared to be protective. While doctors need more studies to
corroborate their findings, they advise infected persons, in the
meantime, to eat food high in vitamins and minerals, and to take
a daily multivitamin.
"CDC Study Finds Five Transfusion-Related AIDS Cases Per Year"
United Press International (10/25/93)
Miami Beach, Fla.--Since screening for HIV began in 1985, very
few people have become infected with the virus via blood
transfusions, according to experts at the Centers for Disease
Control and Prevention. The rate of transfusion-related AIDS
cases rose steadily from 1978 to 1984, then fell dramatically
when testing began in 1985, said the CDC. Officials report that
between 1986 and 1991, the number of such cases may have been as
low as five per year. "While the risk of getting AIDS from a
transfusion is not zero, this study corroborates other CDC
research and published data indicating that the risk is extremely
low," said Dr. Arthur J. Silvergleid, president of the American
Association of Blood Banks. A total of 4,619 individuals are
believed to have been infected through the blood supply. Each
year in the United States, about 4 million people receive blood
transfusions.
"Poll Finds Ignorance on HIV Test"
United Press International (10/24/93)
Tokyo--Only one in five Japanese adults know that tests cannot
determine HIV status until at least three months have passed
since having sex, according to a poll by the National Federation
of Health Insurance Societies. The survey questioned 2,000
randomly selected individuals, and found that 41 percent of the
respondents believe they should take an HIV test soon after
having unprotected sex. Another 21 percent said that taking an
HIV test two weeks after intercourse could produce precise
diagnosis about infection. Lack of knowledge about the test
could, however, falsely convince a person testing negative before
the three-month waiting period has ended that he or she has not
been infected, said a federation official. That faulty
assumption, the official continued, could have "horrible"
consequences for the individual's sex partners. Only 19 percent
of respondents said that HIV tests conducted after three months
following sex could produce accurate diagnoses.
"San Francisco: NAC Trial Recruiting"
AIDS Treatment News (10/01/93) No. 184, P. 7
Herzenberg Laboratory at Stanford University is now recruiting
for participants in an eight-week trial of NAC
(N-acetylcysteine). The goal of the study is to determine
whether oral NAC can replenish glutathione levels in the T cells
of HIV-infected persons. Low glutathione levels are often
characteristic of HIV infection, and it is thought that these low
levels may cause T cells to function less efficiently and cause
faster HIV replication. Volunteers may not already be taking
NAC, OTC, cysteine, or glutathione, and must meet other medical
requirements.
"Is It OK to Lick It?"
Advocate (10/19/93) No. 640, P. 7
Postmaster General Marvin Runyon says he "can't believe there
would be any controversy" about it, yet activists appear to be
dissatisfied with the new AIDS awareness postal stamp that is
being prepared for its Dec. 1 debut. One objection is the stamp
design itself. It features the global symbol of a folded red
ribbon, while many activists preferred the no-AIDS symbol
designed by a Wisconsin nurse. The primary complaint, however,
is that Runyon and the postal service have declined to sell the
stamp for more than its face value, so that proceeds might
benefit the fight against AIDS.
"Alternative Treatment Library Available"
AIDS Treatment News (10/01/93) No. 184, P. 6
The Jon Greenberg Library of Alternative Treatments for HIV
Disease, an anthology of information on alternative AIDS
therapies, is now available from AIDS Project Los Angeles (APLA).
Steven Korsia compiled the collection, working closely with Jon
Greenberg, who died this summer, to gather data for the
publication. In a preface, Korsia cautions readers that many of
the proposed treatments presented are actually not advised at
all, and that each individual must determine the validity of each
therapy. Among the treatments described are blue-green algae,
traditional oriental medicine, colloidal silver, garlic,
licorice, shark cartilage, mistletoe, and polio vaccines. Copies
of the publication are available free to nonprofit organizations,
and at a cost of $30 to all others.
"Assessment of Laboratory Reporting to Supplement Active AIDS
Surveillance--Colorado"
Morbidity and Mortality Weekly Report (10/01/93) Vol. 42, No. 38,
P. 749
The surveillance case definition for AIDS was expanded in January
to include HIV-infected adolescents and adults with CD4 counts
lower than 200, pulmonary tuberculosis, recurrent pneumonia, and
invasive cervical cancer. In preparing for the implementation of
these new criteria, the Colorado Department of Health (CDH)
assessed the usefulness of lab reports of CD4 test results as a
supplement to existing procedures for AIDS surveillance in that
state. The CDH conducted tests in two Colorado labs that perform
CD4 testing, and compared these tests with CDH records of people
with the AIDS virus. The surveillance at these two labs
identified a significant number of AIDS cases defined by the new
case definition. At one lab, 23 percent of persons with CD4 test
results had HIV or AIDS, but had not previously been reported by
CDH; the figure was 6.5 percent at the other lab. Of 108
previously unreported cases of infection, 85 percent were
identified through record reviews indicating an HIV diagnosis in
medical records, but without a lab report of an HIV test.
Without CD4 testing, these patients probably would have remained
unreported until being hospitalized for an opportunistic
infection, or until death. The findings suggest that AIDS case
surveillance may be enhanced by lab reports of CD4 testing, with
provider follow-up or medical record review. Active case
identification is critical in ensuring timely and complete
disease reporting.
"Zidovudine-Resistant Variants of HIV-1 in Brain"
Lancet (Great Britain) (10/02/93) Vol. 342, No. 8875, P. 865
(Stefano, Mariantonietta et al.)
Position changes of amino acids in the reverse-transcriptase (RT)
of HIV have been associated with the development of
zidovudine-resistant strains in the blood. Just hours after
administration of zidovudine, the drug concentration in
cerebrospinal fluid (CSF) is half that found in plasma. It is
uncertain if the resistant variants emerge in the brain as well.
If they do, Stefano et al. thought it would be important to
discover if resistance is defined by the same RT mutations found
in blood isolates, especially since patients taking zidovudine
clinically improve AIDS-related conditions of neurological and
psychiatric natures. HIV was isolated from blood and CSF of four
patients. Resistant strains developed both in the blood and in
the brain compartment 12 to 29 months later. Stefano et al.
concluded that drug-resistant HIV strains can be found in the
brain compartment of patients taking zidovudine, and that the
mutations linked to the resistance in CSF isolates are identical
to those in blood isolates.
"Primary Infection With Zidovudine-Resistant HIV"
New England Journal of Medicine (10/07/93) Vol. 329, No. 15, P.
1123 (Hermans, P. et al.)
Hermans et al. challenge the conclusions of Erice et al., who
described an HIV-positive patient with a primary infection that
showed resistance to zidovudine. Erice et al. suggested that
isolates that are resistant to nucleoside analog drugs are
associated with a higher virulence or modified immune response.
After their subsequent study of the isolates of five acute HIV
patients with resistant strains, Hermans et al. clinically did
not observe any longer duration or greater severity of symptoms
in the subjects. Nor could they find any evidence to support the
conclusions of Erice et al. Hermans et al. reported that the
frequency of such primary zidovudine-resistant strains is still
unknown, but that they are probably more frequent than previously
thought. The researchers said that these findings have
implications for clinical trial design.
------- End of Forwarded Message